Provider Demographics
NPI:1235340753
Name:SWEET, AMY ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ANN
Last Name:SWEET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:ANN
Other - Last Name:TLUSTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4005 COMMUNITY CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WI
Mailing Address - Zip Code:54476-4139
Mailing Address - Country:US
Mailing Address - Phone:715-241-5400
Mailing Address - Fax:
Practice Address - Street 1:4005 COMMUNITY CENTER DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WI
Practice Address - Zip Code:54476-4139
Practice Address - Country:US
Practice Address - Phone:715-241-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47120-020207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics